Financial Conflict of Interests Among Authors

A new study published online by JAMA Oncology quantifies industry financial conflicts of interest (FCOIs) among authors of National Comprehensive Cancer Network (NCCN) guidelines, work that influences practice and defines drugs reimbursable by Medicare.1

Aaron P. Mitchell, M.D., of the University of North Carolina at Chapel Hill School of Medicine, and coauthors examined FCOIs during 2014 among 125 authors of the guidelines for the treatment of breast, colon, prostate and lung cancer because those are the cancers with the highest incidence in the U.S.

The authors used the Open Payments database for FCOIs because the data is publicly reported by the Centers for Medicare and Medicaid Services.

The authors report:

108 of the 125 guideline authors (86 percent) had at least one reported FCOI.Most guideline authors (56 percent) received $1,000 or more in general payments (including consulting, meals and lodging).Guidelines authors received an average of $10,011 in general payments.Guidelines authors received an average of $236,066 in industry research payments (including funding associated with clinical trials).84 percent of authors received general payments, while 47 percent received research payments.Authors note their study was limited in that Open Payments collects data only on physicians so FCOIs of nonphysician NCCN guideline authors were not available.

“More research is needed to determine which kinds of relationships are more likely to produce the unwanted consequence of physician bias to create rational, evidence-based policies that allow for the participation of key clinical experts while managing real or perceived conflicts. Given the prevalence of FCOIs reported here, finding the answer to this question is critical,” according to an article published online by JAMA Oncology.

“The articles in this issue of JAMA Oncology by Mitchell et al and Boothby et al highlight the importance of FCOIs in oncology. Collaborations between industry and oncology researchers and clinicians are common, yet create challenges and opportunities for the oncology community to address,” write Ryan D. Nipp, M.D., and Beverly Moy, M.D., M.P.H., of the Massachusetts General Hospital Cancer Center, Boston, in a related commentary.2

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